Individual
MARY AUZENNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4298 HIGHWAY 31, OPELOUSAS, LA 70570-1407
(337) 308-3448
Mailing address
4298 HIGHWAY 31, OPELOUSAS, LA 70570-1407
(337) 308-3448
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
83-4258708
—
LA
Enumeration date
04/16/2019
Last updated
04/16/2019
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